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What price for performance?

Will the use of ‘smart' drugs change the way we live, work and interact? How soon will it be before a drugs test is the natural precondition for a job interview? Not long, argues Mark Braithwaite, who believes some executives – like some sportsmen and women – will find it difficult to resist the lure of drugs, smart or otherwise, that substantially aid both cognitive and physical performance

14 Feb 2014

Lance Armstrong created and lost a personal fortune of more than $100 million from his drug-fuelled cycling career. We all know the story but Armstrong is definitely not alone as a 'drug cheat' in sport. In a brutally competitive environment, when professional athletes reach the limit of their 'clean' potential, they face tough choices. Cheat, or accept second place.

Sports professionals stop improving when the combination of training, nutrition and genetic endowment are all optimised. The muscle can only do so much. Sports scientists have managed to tune and improve athletic performance consistently over recent years, but every athlete has a limit and the doctor's bag containing EPO, anabolic steroids, testosterone, human growth hormone and more provides real temptation.

What's this got to do with the business performance of executives? A lot more, I will argue, than you might think.

The pursuit of corporate competitive advantage in the business world is and should always be front of mind for every executive. But today, individual competitive advantage is just as important. Executives become executives because they are competitive, and like professional athletes, they naturally take advantage wherever they can. The drug culture that is embedded in professional sport is, I maintain, set to invade the business world.

The debut of 'smart drugs' in business is, probably, inevitable. A number of workers who spoke to news.com.au, the Australian online news site, on the condition of anonymity said the use of the smart drug Modafinil [see below] had grown among workers in competitive, fast-paced industries in recent months. "I think it's a combination of being in a mentally tiring job with a lot of competition and a workload much larger than there are hours in the day," said one 35-year-old Sydney finance worker who had tried the drug after reading about it online.

"The stories I read were all very positive, and being in a busy stressful job with not enough time, it's exciting to think there might be something that can give you an edge on the competition, but mostly to combat exhaustion."

Evidence shows, however, that smart drugs do not in fact increase IQ, but alter brain chemistry in a way that allows access to everything we have available. Is this really cheating?

When you think about drugs in sport, the mind naturally goes straight to cyclists and 100 metre runners who use drugs to enhance muscle performance. What most people don't really think about is that other sportsmen such as golfers and tennis players may be using drugs to relax or focus for long periods of time.

The drugs used by Lance Armstrong were not developed for sport but to treat illness. The by-product was that those drugs were found to also enhance physical performance in athletes. Similarly, some drugs developed to treat cognitive illnesses have been proven to enhance cognition in the healthy. Drugs developed to treat debilitating diseases of the mind are suddenly in demand by the healthy as smart drugs or cognitive enhancers.

Put succinctly, smart drugs work by altering the supplies of neurotransmitters, enzymes and hormones that affect the brain. Though not everything is known about them, it is thought that they modify neurochemical supplies, reducing noise levels and allowing signals in the brain to be clearer, thus increasing the quality of information flow in the brain: surely something that any executive would be keen to have at his or her disposal.

But do they really work?

Professor Barbara Sahakian, Professor of Clinical Neuropsychology at the University of Cambridge, in collaboration with the University's Department of Psychiatry and Imperial College London's Division of Surgery, recently commented on a study that discovered that the smart drug Modafinil improves cognitive flexibility and reduces impulsivity in sleep deprived doctors. Approved by the US Food and Drug Administration, Modafinil is a wakefulness-promoting drug that aids those with narcolepsy, those suffering from shift-work sleep disorder and those suffering from other sleep-related conditions.

However, the ethics of using smart drugs such as Modafinil are rather complex. For example, if you were booked in for surgery and you knew that a doctor using Modafinil would be able to perform better, perhaps you would not be too concerned with the ethical questions surrounding it. But what if you were interviewing to hire a new CFO and found out that the candidate was using smart drugs to help them in the interview? Might you think otherwise?

There is a belief that improved regulation might open the floodgates to a new brand of highly developed smart drugs. Critics worry not that cosmetic neurology might help individual fighter pilots or surgeons strive for better performance, but that the widespread use of cognitive enhancers might provoke a pharmaceutical 'arms race' widening inequalities in competitive environments like the worlds of business or education. In other words, warns Roger Cohen of the New York Times, "what starts as a matter of individual choice can quickly become one of collective coercion".

Perhaps of deeper concern is the fact that these drugs are already being widely used by the next generation of executives currently in college or university.

In a study published in the Journal of American College Health of more than 1,800 undergraduates, 34 per cent admitted to the use of ADHD stimulants. Studies in the UK and Switzerland came up with similar results. These students were using prescription drugs that were not prescribed for them. It's a deeply worrying trend.

As business people, we get ahead by being smarter than our competition. Like the athlete who reaches the upper limit of his or her natural ability, the concept of popping a pill to be smarter could be too much of a temptation for some to resist. For the next generation of graduates though, it is already the norm.

So, how smart do we need to be?

Garry Kasparov, the Chess Grandmaster, is reported to have an IQ of 190. This is scary smart. You need to be about 115 to get marks good enough for university entrance. The borderline for gifted is around 130 and 150 gets you the Mensa 'genius' title. If you ever visit a chess club (and I have), you will see a room full of odd-ball people who would all pass the Mensa entry test but cannot hold much of a conversation.

The point here is that all intelligence is not equal. IQ just measures raw computing power. Malcolm Gladwell in his book Outliers says that once someone has reached an IQ of somewhere around 120, "having additional IQ points doesn't seem to translate into any measurable real-world advantage".

But surely being smarter would be better? We have all felt this at one time or another. Just spend 15 minutes with someone you consider to be brilliant and cognitive envy creeps up on you. No scientific proof is needed for this one.

The big question then is can we really get smarter? We all have good days and bad days. There are days when we can perform at the top end of our ability and days when we are just sluggish, both physically and mentally.

Our IQ did not change. It's just that on the good day we got to take the Ferrari out for a spin, while on the bad day, it had a flat tyre. We each have a trading range of our personal cognitive performance and it's all about chemical interactions in our brain that set the scene for how we will perform on any given day.

Executives need to be able to perform every day. A high salary comes with high demand. Making the best decisions quickly, multi-tasking, prioritising a list that is longer than the hours in the day and moving from processing facts to dealing with emotion are just a few of the conflicting pressures. Those pressures don't stop, so high energy and a need to focus for 12 hours or more every day is just part of the job.

We reach our physical peak in our 20s, but we also reach our cognitive peak at the same time. Like the slow physical decline we see with age, we are also on the slow slide of cognitive decline. It's just not on view to the world like our ageing bodies.

Sports scientists have worked relentlessly to figure out how athletes can have a good day every day. It's a complex science but the manipulation of nutrition, exercise, rest and sleep are the key variables.

Similarly, cognitive performance – in the boardroom or elsewhere – is maximised in the same way, but most of us have completely missed this.

Specialists treating ADHD are now using lifestyle manipulations before drugs and getting great results. Interestingly, the lifestyle manipulations are identical to those used by the sports scientists: nutrition, sleep, exercise, stress management and so on. Like the sports pro though, drugs come into play when the results are just not enough.

Dr Fernando Gómez-Pinilla from the Departments of Neurosurgery and Physiological Science at UCLA believes that "…specific nutrients can affect cognitive processes and emotions. Newly described influences of dietary factors on neuronal function and synaptic plasticity have revealed some of the vital mechanisms that are responsible for the action of diet on brain health and mental function."

He adds: "Several dietary components have been identified as having effects on cognitive abilities." Fish oil and ginkgo biloba tea are at the top of the list, while saturated fat is the biggest no-no as far as our brains are concerned. He also concludes that the cognitive enhancement gained from good nutrition is amplified when combined with exercise and the right amount of sleep. This is not exactly news but how many executives really adhere to this simple but effective mix of good diet, exercise and regular sleep?

The digital disruption (otherwise known as sheer panic) senior executives suffer from when they spend just a few minutes away from their email, cell phone, social media touch points or tablet is probably causing serious harm not just to their cognitive power but to their ability to behave clearly and effectively.

In today's world though, few are prepared to sacrifice the trappings of modern life – electronic or otherwise – for a truly healthy regime, even if their lifestyle is holding them back from reaching their true cognitive potential.

The science journal Nature published a paper by Dr Charles Hillman and others from the University of Illinois, titled 'Be Smart, exercise your heart: exercise effects on brain and cognition'. It declared: "Physical activity training appears to have both broad and specific cognitive effects: broad in the sense that various different cognitive processes benefit from exercise participation, and specific in the sense that the effects on some cognitive processes, especially executive control processes (which include scheduling, planning, working memory, multi-tasking and dealing with ambiguity) are disproportionately larger."

While smart drugs are creeping towards the mainstream (and even into the boardroom), so is the science of cognitive training. Phone apps such as Lumosity take the user through a series of daily puzzle challenges that are claimed to improve cognition through regular 'brain exercise'. There is plenty of evidence to support that this kind of exercise does in fact yield significant, positive results.

Cognitive scientist Mark A. Smith, from the Center of the Neural Basis of Cognition at Carnegie Mellon/Pittsburgh Universities, explains: "Far-reaching advances in cognitive psychology and cognitive neuroscience over the past decade have identified a close link between frontal lobe 'working memory' circuitry, and fronto-parietal problem solving and reasoning circuitry – core elements of IQ. Our working memory is used for holding information in mind (images, concepts, language and numbers) for brief periods while engaging in active, goal-focused thinking or comprehension, while screening out distracting information. Working memory has a limited capacity, and the bigger that capacity the more the cognitive 'RAM' power a person has for processing information – to make connections, generate alternatives, and grasp relationships. This brainpower lies at the core of being smart. If super brain Eddie Morra in the movie Limitless changed one thing in his brain, it was his working memory circuitry!"

The working memory is, then, rather like the RAM of a computer. The more programs you have running, the slower the computer runs. Overload it too much and it crashes. It seems that like the PC, we need to reboot, too. This means taking away the demand and stimulation for a while by doing something different like walking, gardening, surfing, yoga or whatever is your own preference. Just not more work.

Daniel Golman's work supports the concept of working memory being a critical component of our cognitive performance and our ability to use our intelligence fully. It was Goleman who brought us the term 'emotional intelligence'. His latest book, Focus, the Hidden Driver of Excellence, teaches how to use our full intellect and at the heart of this is our working memory.

For most of us, the concept of improving our cognitive potential is new. In fact, getting started is a bit like taking up running. The more serious we are about the training, the faster and further we will be able to run.

Science is telling us to take a brisk walk to the supermarket, buy an apple or a piece of fish, download some IQ training software, pass on that extra glass of wine and have a good night's sleep. You might want to take some ginkgo biloba and fish oil, too. Tomorrow we will be better than today. People using smart drugs today, though, have no idea what the long-term effects might be.

Most cognitive studies seem to work with healthy college-age volunteers or old people with well-advanced, age-related cognitive decline. Not surprisingly, the results from interventions in older people are more pronounced. Most of you reading this will be in neither group, but it seems that we have more potential to improve than the 22-year-old volunteer at his or her peak.

But where is the line between looking after your health and being a drug cheat?

Most sports scientists don't support the use of 'illegal' drugs in sport, but they know it is all around them. Athletes who dedicate their lives to their sport will often do anything to win. Business people take risks all the time and the possibility of using drugs to achieve an advantage may be just too tempting. But beware: although smart drugs do increase concentration, some users have found themselves becoming too focused, even obsessive, on a small part of the overall workload. As a result they complete less work, and smart drugs have ended up hindering rather than helping their studies. Pharmaceutical companies will continue to invest in trying to cure diseases that cause cognitive decline, as there is big money in being the producer of the most effective drug for, say, Alzheimer's or Parkinson's disease. As each generation lives longer, the commercial potential for these drugs is huge and growing.

The question then remains: how long will it be before drug testing will take place before job interviews?